EP0359987A2 - Canule en acier pour l'anesthésie spinale et péridurale - Google Patents

Canule en acier pour l'anesthésie spinale et péridurale Download PDF

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Publication number
EP0359987A2
EP0359987A2 EP89114964A EP89114964A EP0359987A2 EP 0359987 A2 EP0359987 A2 EP 0359987A2 EP 89114964 A EP89114964 A EP 89114964A EP 89114964 A EP89114964 A EP 89114964A EP 0359987 A2 EP0359987 A2 EP 0359987A2
Authority
EP
European Patent Office
Prior art keywords
tube
steel cannula
tip
end section
spinal
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP89114964A
Other languages
German (de)
English (en)
Other versions
EP0359987A3 (fr
Inventor
Hans-Günter Dr. Haindl
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
B Braun Melsungen AG
Original Assignee
B Braun Melsungen AG
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by B Braun Melsungen AG filed Critical B Braun Melsungen AG
Publication of EP0359987A2 publication Critical patent/EP0359987A2/fr
Publication of EP0359987A3 publication Critical patent/EP0359987A3/fr
Withdrawn legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3401—Puncturing needles for the peridural or subarachnoid space or the plexus, e.g. for anaesthesia

Definitions

  • the invention relates to a steel cannula for spinal and epidural anesthesia according to the preamble of claim 1.
  • cannulas with a cutting or tearing puncture tip are used in spinal or epidural anesthesia, there is a risk of vascular, dural and nerve injuries. In particular, bleeding in the epidural space, transient to persistent neuronal failures and postspinal headache can occur. Post-spinal headache is a pain that is difficult to treat and can persist up to several days after spinal anesthesia and is very painful for the patient. Liquorleck syndrome is postulated as the cause of this today. When designing spinal cannulas, attempts are therefore made to keep the injury to the dura as small as possible, so that as little puncture as possible from the dura after the puncture is complete can kick. Attempts are also being made to keep the loss of CSF from the patient lying flat.
  • the tube of the steel cannula was made extremely thin overall and provided with a quince cut at the tip.
  • practically no free CSF can be achieved anymore which is undesirable because reaching the destination with the tip of the cannula, which is indicated by CSF backflow, cannot be recognized with sufficient precision.
  • there is a tendency to kink so that they do not perforate the hard dura of the spinal canal in a straight line, but deflect laterally and the front opening of the tubular canal, through which anesthetic is to be injected, does not reach the spinal canal.
  • atraumatic tips In order to penetrate the dura with a spinal cannula without injury, so-called atraumatic tips have also been formed on spinal cannulas. These have the shape of a closed pointed cone, behind which one in the pipe wall channel leading opening is formed (DE-PS 30 20 926). Such atraumatic tips have considerably higher penetration forces than cutting tips and they only produce a small puncture hole when piercing the dura, which is mainly created by displacing the elastic fibers of the dura and largely closes after the cannula has been pulled out. Even with such spinal cannulas, however, the stylet must be pulled out completely to check the CSF reflux and the reinsertion is problematic.
  • the atraumatic spinal cannulas cannot be produced in such thin sizes as the first-mentioned Quink cannulas, so that a combination of a very thin tube with an atraumatic tip which is intrinsically favorable for puncturing the dura is not possible.
  • the invention is based on the object of optimizing a steel cannula for spinal and peridural anesthesia of the type mentioned at the outset in such a way that it combines the advantages of a thin tube with improved tip localization by facilitating checking of the CSF reflux.
  • This object is achieved in that the outer diameter of the tube and the diameter of the tube channel are reduced on a front cylindrical end portion and that the stylet substantially fills the circumferential end of the narrowed tube channel end portion.
  • a steel cannula designed in this way is thin only in the area in which it perforates the dura. In their remaining, longer course, both their outside diameter and their inside diameter, ie the cross section of their pipe duct, are larger. Due to this different dimensioning of two coaxially successive sections of the tube, the steel cannula, which is easier to insert with the thinner end section and has a very small puncture hole through the hard meninges (dura) of the spinal canal, has good stability and free liquor reflux is achieved in the enlarged tubular channel cross section. It is particularly advantageous with regard to handling and hygiene that the mandrin no longer has to be completely pulled out of the tube of the steel cannula to check the position of the tube tip by checking the liquor backflow.
  • the tube is hammered together at its front end section on a mandrel to a lesser thickness and that thickened walls are ground over.
  • the front end section is hammered together to a thickness of approximately 26 G (0.45 mm).
  • a puncture tip is then attached to this thin front end section, which may only have slight lateral offset forces, so that the tissue fibers to be penetrated are only pushed apart, but not cut as far as possible.
  • a design according to claim 4 is suitable as a piercing tip.
  • Such a piercing tip with a sideways opening is characterized by a reduced punching effect because the lancet-shaped, one-sided curved piercing part results in a symmetrical widening of the tissue up to the outer diameter of the tube of the steel cannula, which closes tightly after pulling out the steel cannula.
  • a piercing tip in the form of a closed pointed cone, behind which the opening is formed in the tube wall, is also suitable for the thin front end section of the steel cannula according to the invention for spinal and epidural anesthesia.
  • the transition from the larger to the smaller diameter of the pipe and the pipe channel is advantageous designed as an elongated conical section that does not form a step, but provides a continuous transition between the two coaxial diameters.
  • the elongated conical section has the task of guiding the tip of the stylet evenly into the narrowed tube channel end section, if the mandrin is checked at regular intervals to control the CSF backflow a short distance has been withdrawn into the larger diameter duct.
  • the tube being attached to a transparent grip sleeve with a conically widened cavity.
  • the conical extension forms a kind of funnel, which simplifies the insertion of the thin stylet without particular accuracy.
  • the steel cannula 10 for spinal and epidural anesthesia consists essentially of a straight cylindrical tube 11 made of steel, at the front End is formed a piercing tip 12 and the rear end is attached to a grip sleeve 13 made of transparent material.
  • a cylindrical tube channel 15 which opens at the front at a side opening 14 and at the rear at a central passage 16.
  • a cylindrical connecting piece 20, into which the pipe end is glued, is used to fasten the rear end of the pipe 11 to the grip sleeve 13.
  • the grip sleeve 13 is concentrically penetrated by a conically widened cavity 21 which is composed of two coaxially successive conical sections 22, 23 of different opening widths.
  • the rear conical section 23 ends openly and on its edge the grip sleeve 13 is provided with radially outwardly directed lugs 25 which serve as locking elements for the coupling part of a syringe, not shown.
  • the outer diameter of a front short cylindrical end portion 11a of the tube 11 is smaller than the outer diameter of a long cylindrical tube portion 11b and also the inner diameter of the tube 11, i.e. the cross section of its pipe duct 15 changes from a long pipe duct section 15b of larger diameter to a short pipe duct end section 15a of smaller diameter.
  • the pipe 11 has an elongated conical section 11c at the front end of its larger-diameter pipe section 11b, which causes a gradual transition of both the outer and the inner diameter of the pipe 11 to the narrowed end section 11a, 15a.
  • a stylet 30 made of steel concentrically.
  • the stylet 30 has a circular cross section and its thickness is so measure that it approximately fills the narrowed pipe channel end portion 15a circumferentially.
  • the tip 31 of the mandrel 30 is ground so that it fills the ground eye 17 of the opening 14 without a step.
  • a conventional extension 26 is fastened, which engages with an outer cone 27 in the inner cone of the cavity section 23 in a sealing manner and encloses the radial extensions 25 in a cap-like manner with a circumferential jacket 28 which is arranged at a distance from the outer cone 27.
  • the piercing tip 12 has a convexly curved wall side 35 which, with the opposite straight wall side 36, delimits the lateral opening 14 which is provided with a rear cutting edge 37 and a lancet-shaped front piercing part 38 ending in a tip.
  • the tip of the piercing part 38 lies in the area between two imaginary parallel lines, which extend the inner surface and the outer surface of the straight wall side 36 beyond the rear cutting edge 37 to the front.
  • the lancet-shaped front piercing part 38 is provided with facet grinding and, with a supplementary opening edge grinding, forms the grinding eye 17, which is suitably closed by the adapted grinding surface of the tip 31 of the stylet 30.
  • the puncture tip 12 shown is characterized by a reduced punching effect which, in conjunction with the narrowed front end section 11a of the tube 11, means that the dura is practically not injured and the puncture opening closes again immediately after the cannula has been pulled out, so that after the puncture is complete very little liquor can leak out of the dura and counteract post-spinal headache.
  • Free liquor reflux for localization of the piercing part 12 is ensured by the pipe duct section 15b of larger diameter as soon as the stylet 30 is withdrawn by the length of the narrowed pipe duct end section 15a.
  • the grip sleeve 13 with the stylet 30 is withdrawn until the tip 31 of the stylet 30 has left the narrowed pipe channel end section 15a. Since the front end portion 11a is preferably about 15 mm long, the user only has to withdraw the stylet about 15 mm in order to be able to assess the backflow of the liquor, which is unobstructed due to the reduced flow resistance in the pipe channel portion 15b.
  • a cylindrical straight tube 40 is made thinner at its front end section 40a, and accordingly the front cylindrical tube channel end section 41a of the tube channel 41 is narrowed.
  • the front end section 40a is straight and is closed by a piercing tip 43 designed as a closed pointed cone 42.
  • a piercing tip 43 designed as a closed pointed cone 42.
  • an opening 44 with a circular or square cross section in the tube wall, the edge of which has a special grinding.
  • a stylet 45 which closes the opening 44 during the puncture and whose withdrawal from the front end section 40a of smaller outer and inner diameter of the tube 40 enables free liquor reflux, which indicates that the spinal space has been reached.
  • the transition between the pipe section 40 of larger diameter and the end section 40a of reduced diameter also takes place in this example via an elongated conical section 46, which facilitates the insertion of the mandrel 45 into the narrowed pipe channel end section 41a and a non-stop puncture of the thin end section 40a into the hard meninges of the spinal canal.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Pathology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Anesthesiology (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Infusion, Injection, And Reservoir Apparatuses (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Prostheses (AREA)
  • Surgical Instruments (AREA)
EP19890114964 1988-09-20 1989-08-12 Canule en acier pour l'anesthésie spinale et péridurale Withdrawn EP0359987A3 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE8811891U 1988-09-20
DE8811891U DE8811891U1 (de) 1988-09-20 1988-09-20 Stahlkanüle für die Spinal- und Periduralanästhesie

Publications (2)

Publication Number Publication Date
EP0359987A2 true EP0359987A2 (fr) 1990-03-28
EP0359987A3 EP0359987A3 (fr) 1991-06-26

Family

ID=6828111

Family Applications (1)

Application Number Title Priority Date Filing Date
EP19890114964 Withdrawn EP0359987A3 (fr) 1988-09-20 1989-08-12 Canule en acier pour l'anesthésie spinale et péridurale

Country Status (2)

Country Link
EP (1) EP0359987A3 (fr)
DE (1) DE8811891U1 (fr)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0522737A1 (fr) * 1991-07-08 1993-01-13 Baxter International Inc. Corps porteur transparent pour canule
EP0529341A1 (fr) * 1991-08-28 1993-03-03 VYGON GMBH & CO KG Trousse pour l'anestésie
WO1993014710A1 (fr) * 1992-01-29 1993-08-05 Al Rawi Muthafar Muflih Canules et aiguilles de petit diametre
EP0900546A1 (fr) * 1997-09-05 1999-03-10 Irene Cristina Luis Vega Assenblage catheter à aiguille utilisé dans des thérapies médicales ou vétérinaires
DE20018216U1 (de) * 2000-10-24 2002-02-28 Süddeutsche Feinmechanik GmbH, 63607 Wächtersbach Anästhesiebesteck
DE10053883A1 (de) * 2000-10-31 2002-05-29 Pulsion Medical Sys Ag Hohlnadel
DE102007031799B3 (de) * 2007-07-07 2008-10-16 Haindl, Hans, Dr. med. Kanülenvorrichtung zur Entnahme von Rückenmarksflüssigkeiten (Liquor)

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1994006359A1 (fr) * 1992-09-22 1994-03-31 Hans Haindl Canule en acier pour anesthesies spinales et peridurales

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE935625C (de) * 1952-10-18 1955-11-24 Guenther Bodendieck Exzisionsgeraet
US3540447A (en) * 1967-09-29 1970-11-17 Becton Dickinson Co Spinal needle
DE3020926A1 (de) * 1980-06-03 1981-12-10 Heinrich 7716 Geisingen Pajunk Kanuele, insbesondere fuer die lumbalpunktion und -injektion
DE8616477U1 (de) * 1986-06-20 1986-08-21 Uromed Kurt Drews, 2000 Oststeinbek Stichinstrument für die perkutane Nephroskopie

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE935625C (de) * 1952-10-18 1955-11-24 Guenther Bodendieck Exzisionsgeraet
US3540447A (en) * 1967-09-29 1970-11-17 Becton Dickinson Co Spinal needle
DE3020926A1 (de) * 1980-06-03 1981-12-10 Heinrich 7716 Geisingen Pajunk Kanuele, insbesondere fuer die lumbalpunktion und -injektion
DE8616477U1 (de) * 1986-06-20 1986-08-21 Uromed Kurt Drews, 2000 Oststeinbek Stichinstrument für die perkutane Nephroskopie

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0522737A1 (fr) * 1991-07-08 1993-01-13 Baxter International Inc. Corps porteur transparent pour canule
EP0529341A1 (fr) * 1991-08-28 1993-03-03 VYGON GMBH & CO KG Trousse pour l'anestésie
WO1993014710A1 (fr) * 1992-01-29 1993-08-05 Al Rawi Muthafar Muflih Canules et aiguilles de petit diametre
EP0900546A1 (fr) * 1997-09-05 1999-03-10 Irene Cristina Luis Vega Assenblage catheter à aiguille utilisé dans des thérapies médicales ou vétérinaires
DE20018216U1 (de) * 2000-10-24 2002-02-28 Süddeutsche Feinmechanik GmbH, 63607 Wächtersbach Anästhesiebesteck
DE10053883A1 (de) * 2000-10-31 2002-05-29 Pulsion Medical Sys Ag Hohlnadel
DE102007031799B3 (de) * 2007-07-07 2008-10-16 Haindl, Hans, Dr. med. Kanülenvorrichtung zur Entnahme von Rückenmarksflüssigkeiten (Liquor)

Also Published As

Publication number Publication date
DE8811891U1 (de) 1988-11-24
EP0359987A3 (fr) 1991-06-26

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